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Choosing a Midwife: The Second Time Around

When I was discharged from midwife care after having K, they jokingly told me that the next time I got pregnant, I should call them before I called my husband. That was their way of saying that midwife care, especially in my small city, books up FAST – as soon as there was a chance I might be pregnant, I should get my name on the list.

I had a wonderful experience with midwives the first time around. The care I received was incredible; they spent an average of 40 minutes per appointment with me, discussing all of my options, everything there was to know, answering questions, and providing me with the information to make informed decisions. I weighed the pros and cons of twelve week screening, of receiving tests for group B strep and other things, all the way down to being given the option of a hospital birth or a home birth. I appreciated the care and time they took, and, as a first time mom, I loved that they answered all of my questions without making me fee l like, well, a first time mom. Post-partum, they came to my house six or seven times, to check up on Little Oats, to check in on me, to help me with everything from breastfeeding to establishing a routine, to getting me into the emergency room with no wait time when my stitches wound up infected. When I was discharged from care at six weeks postpartum, I was honestly sad to say goodbye to my friends and primary caretakers.

And yet, when I got pregnant with Baby #2, there was still a question in my mind. Should I go with my family doctor, who has been delivering babies for ages, and has provided excellent care? Or should I stick with the midwives, who were wonderful and whom I know? There was really one reason that I was debating, and one reason only:

The epidural.

After 40 hours of labour with K, I asked for an epidural, which resulted in my care being transferred, last minute, to the OB on call. I had never met him and I couldn’t tell you his name; he never even introduced himself. The midwives in my province don’t have license to oversee the care of someone with an epidural, so instantly, their hands were tied. They could care for my baby, but as far as my care was concerned, the OB was in control. I hated this aspect of my care; after 41 weeks of being carefully watched by the midwives, I was now left to the mercies of an on-call OB (who didn’t know my name) to deliver my baby. It ended up working out all right, because the OB was in an emergency surgery when K was actually born, so he didn’t have anything to do with her birth, but on all of my birth records, it still states his name as being the attending doctor.

To avoid this the second time around, I could be under the care of my family doctor. I would see him until 26 weeks, when my care would be transferred to an OB that I would actually get to meet several times. This OB would be able to prepare me for an epidural, should I want one, and would (hopefully) be the one on call to deliver Baby #2. There would be no transfer of care during labour, no real uncertainty, and no chance that the drugs wouldn’t be available when I wanted them.

Herein lies the dilemma. Do I go with the midwives, knowing that if I end up with an epidural, my care will be transferred again? Or do I go in with the expectation of an epidural, and see an OB from the start? Do I have faith in myself that this time, I can make it epidural-free? Or do I even bother to try, knowing that I have pain meds available to me whenever I like? My decision making process had really come down to a fight between med-free birth and medicated birth; a decision that’s difficult to make at 5 weeks pregnant.

Though it seems like this debate went on in my head for ages, it was really settled within about a day of my positive pregnancy test. I knew that, despite the confusion my transfer of care caused during my labour with K, the uncertainty of it all was worth the impeccable care I would receive for the majority of my pregnancy, labour, and birth. With any pregnancy, there’s that sense of the unknown; even if I had chosen an OB, there was no guarantee that the same OB would be on call to deliver Baby #2, leaving me in the same boat (but with pain meds). With choosing the midwives, I could be guaranteed that one of my team of 3 midwives would be the one with me at the hospital, and as long as all went well, be the one to deliver Baby #2.

I called my midwives office at 5 weeks pregnant, and sure enough, I was one of the last on the roster for September 2015. On my first visit, I was pleasantly surprised to realize that my primary midwife this time was the same as with K. We spent ages catching up, sharing photos of the baby that she hadn’t seen since our final appointment at 6 weeks postpartum. We chatted about my expectations for this pregnancy, and ultimately, it felt a little like coming home.

I’ve been to see them a handful of times now, and my decision was the right one for us. I’m excited for the rest of this pregnancy, and I’m looking forward to the birth experience I’ll have this time around.